硼替佐米序贯移植方案治疗多发性骨髓瘤患者不同疗程的疗效观察

Observed the efficacy of bortezomib sequential transplant program for multiple myeloma patients with different course of treatment

目的探讨硼替佐米序贯移植方案治疗多发性骨髓瘤患者不同疗程的疗效。方法选择于2013年1月至2014年12月接受治疗的72例MM患者,将所有接受治疗的MM患者按疗程阶段分为3阶段,分别为1个疗程、3个疗程及6个疗程。对MM患者均采用以硼替佐米为主联合地塞米松和阿霉素的中西医结合方案治疗,观察术后一年内的临床疗效。结果术后自体造血干细胞的表面因子的阳性率均显著优于术前,差异均具有统计学意义(P<0.05)。硼替佐米治疗3个疗程和6个疗程后患者的免疫学指标均显著优于术前,差异具有统计学意义(P<0.05,但是1个疗程与术前的差异无统计学意义(P>0.05)。硼替佐米治疗3个疗程和6个疗程后患者的MM常规指标的综合评估均显著优于术前,差异具有统计学意义(P<0.05),但1个疗程与术前的差异无统计学意义(P>0.05)。硼替佐米治疗3个疗程和6个疗程对应的临床显著疗效指标均显著优于治疗1个疗程,差异具有统计学意义(P<0.05)。硼替佐米1个疗程治疗和6个疗程治疗的不良反应与并发症发生率对比,差异无统计学意义(P>0.05)。结论硼替佐米序贯移植方案对MM患者有改善的临床疗效,但是3个疗程以上的疗效更为理想,具有十分重要的临床应用和推广价值。

Objective To investigate the efficacy of sequential transplantation with bortezomib different in patients with multiple myelo-ma. Methods 72 patients were selected treated MM patients in the hospital from January 2013 to December 2014,all treated MM patients were divided into three stages of treatment stages,namely one,three and six course of treatment. All MM patients were treated with bortezomib - based dexamethasone and doxorubicin integrative medicine program,the clinical efficacy of postoperative were observed. Results The positive rate of postoperative autologous hematopoietic stem cell surface factor were significantly better than those of preoperative patients,the difference was statis-tically significant（ P ﹤ 0. 05）. Immunological parameters after 3 courses and six courses were significantly better than the preoperative,the differ-ence was statistically significant（ P ﹤ 0. 05）,but the difference after a treatment course was not statistically significant（ P ﹥ 0. 05）. Compre-hensive assessment of conventional indicators after 3 courses and six courses were significantly better than those of preoperative,the difference was statistically significant（ P ﹤ 0. 05）,but the difference after a treatment course was not statistically significant（ P ﹥ 0. 05）. Corresponding indi-cators and clinical significant efficacy after 3 courses and 6 courses were significantly better than one course of treatment,the difference was statisti-cally significant（ P ﹤ 0. 05）. The incidence of adverse reactions and complications between one and six or more cycles of therapy had no statisti-cally significant difference（ P ﹥ 0. 05）. Conclusion Bortezomib sequential transplant program is good to improve clinical efficacy in patients with MM,but the effect of more than 3 courses is more ideal.